| NPI | 1528325735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 56801) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 311261-01) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2022-06-30 |